Apr 23 Health care: Duluth's changing profession

By Elayne Crecelius
The implications of Obama’s new health care reform has brought major changes to the health care profession throughout the country.

The new bill means health insurance will cost $940 billion over the next ten years and insure over 32 million Americans who are currently uninsured, according to CBS News: Politics’ website.

With more people potentially visiting health care facilities, the need for rural and outlying health care facilities could soon be on the rise.

Minnesota has 76 certified health care clinics compared to the 3,755 across the U.S., according to a comparison done by the Kaiser Family Foundation.

St. Mary’s Medical Center (SMDC), located in Duluth, does their part to offer quality health care to outlying neighborhoods in the Twin Ports area. They also reach rural and outlying towns and areas throughout Minnesota, Wisconsin and Michigan.

“We typically look at where we can realistically have a clinic in a particular area where we can get people to come to Duluth,” said Mike Motely, SMDC’s vice president of regional operations.

In total, SMDC has 17 clinics in outlying communities including West Duluth, Lakeside, Hermantown, and Superior. The farthest outlying clinic is in International Falls.

The placement of the clinics is determined by where SMDC will be able to “capture the market.” This ensures that when specialty medical situations arise, patients who have no specific preference to where they are treated choose the SMDC main campus in Duluth, Motley said.

“Patients always have the choice of where they want to go for care,” Motley said. “If they aren’t adamant to where they want to go, we try to keep them in our system.”

Motley said there are some clinics in the network that are easier to staff than others when trying to staff outlying and rural clinics.

“If we want to recruit to Ely and we open up the recruitment, we will sometimes get fifteen applicants,” Motley said. “In Virginia, we might get one,”

Motley explained that as a city, and part of the region, Virginia is just not as desirable of a tourist spot as Ely.

“It takes a special person to want to live in International Falls,” Motley said, in regards to their farthest clinic in International Falls. “Recruitment is very hard.”

To help alleviate some of the issues facing rural health care, the medical school at the University of Minnesota Duluth (UMD) has made it their mission to “be a leader in educating physicians dedicated to family medicine,” according to the school’s website.

“Our goal since the beginning is to train family physicians,” said Dr. Raymond Christensen, the assistant dean for Rural Health at UMD.

Christensen said the need for rural physicians is great.

“The positions, the demand as it is there is a need for an additional 150 doctors in the rural setting,” Christensen said. “You can argue the numbers up and down but there is still a need,”

The medical school at UMD does what they can to help to ensure that students coming through their doors will choose and also stay with family medicine, Christensen said. This includes looking at what areas students come from, particularly rural communities, to help them understand what they would be getting into in the rural medicine setting, he said.

In order to keep students interested in rural medicine, he said it’s all about the student selection.

Christensen said he hopes the recently passed health care reform bill will help with the need for the rural medicine practice situation, as well as make it more appealing to prospective students.

“The way it was written there are a lot of rural components in the health care bill,” he said.

Some of the reimbursement factors include the salary that is associated with different areas of the medical field. Christensen said the pay in the medical field sometimes makes it harder for students going into family medicine to stay with it. Medical school, starting next year, will be anywhere between $30,000 and $33,000, according to Christensen.

“When a student comes out of school $160,000 in debt, you want to work in a specialty where you can get that back fast and family medicine is not that specialty,” he said.

While money may play a role in some students’ decision in whether or not to go into family medicine, James G. Boulger Ph.D., also of the UMD Medical School said studies have been done between what specialties students pick and the pay of that particular profession, and there is not a strong correlation.

“The money is not why you do what you do,” Boulger said. “If you take the folks in that want to do certain things, you are going to get more out of them.”

Boulger added that by picking certain students and training them for rural medicine, like UMD does, the likelihood of those students going into rural health is very high.

“UMD is top in the country for students going into rural health” Boulger said.

By following the mission of the medical school, and specializing in training students specifically for rural health, he said. They can continue to turn out numbers substantially above the national average.

According to Boulger, a study done nationally shows that only 4 percent of those going into the medical field choose rural health care. At UMD, 48 percent of the students choose rural health care.

“We’re not following national trends,” Boulger said. “From the very beginning of the school, we are running four to five times that of the national average; pick the right ones, train them how to do it, and they’ll do it.”

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